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HomeMy WebLinkAbout915 LAPORTE AVE - APPLICATIONS - 5/23/2016COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICE Fbet0 II :IS 281 N.'Coll' a Ave. Fo't Collins :C0;80524 Phonee':970-016.2740 f wwW fdgov . orWbullding . BUILDING PERMIT APPLICATION . J f APPLICATION NUMBER � Q APPLICATION: DATE � �� '` Job Site Address Xve- Unit.# PROPERTY' OWWER INFO:. (All owner tnfor�natton.is required - It is not optional) Phone # el7 b q / Z Last name X t ('t`C k First Name i • �`� Middle Street Address C1 1 S City T�a—r+ 00 1I I n S State ® zip — CO . N RACMk INFO: Company .Nam e �4. riAK �6v►" . Contractor Phone:# `Z l4 G6 77 Lie Holder flame � �"T ��- �e� City of Fort .C6llliift License # V`�� .Supervisor Cert# 6 Mailing.Address 4-co�'"i1� City c� -.4. `�f K`7 State: .,C© Zip. LEGAL INFQ _ a Subdivision/PUD I � f3 7 S C' d 7 l Filing* Lot # Block.#. Lot. Sq Ft CONSTRUCTION INFO: Total Building Sq Ft(not indudin9 basement) Tofal; Garage:Sq: Ft Residential Sq Ft Comm'I Sq Ft . # of Stories Bldg: Height # Dwelling Units 15 Floor Sq Ft 2nd Floor Sq Ft 3" Floor Sq Ft Unfiished Bsmt Sq Ft Finished Bsnrt Sq Ft # of.Bedrooms . # of:Full Baths . 3/.. Baths . '/. Baths.. # of Fireplaces ElAir Conditioning. Ye N Energy info: (Ci►c!e appropiiate. choice) 1:.;GomCheck. '2: ResCheck`w/Air Sealing: 3. ResCheck w/Blower Door 4: Simulated: Performance Altemativ `. &. Prescriptive i Air Sealing :: ; .. it. Prescriptive inrl Blower Doo0 City of Fort Collins Stock Plan# . List approodate option #s UTILITIES INFO: Water Tap Size $ewer Tap Size Metered: YesaNa Temp. Pedestal YesD No Type of Heat: Gas[]Electric Electric Main Breaker Size (Residential only) 0156 Amp`( Less:❑200.Amp Other Value of Construction. (including labor, Material &.profit) $ Contact Name'& Phone # ofJOBSITE SUPERVISOR: I -Zia47 Subcontractor Info: r Electrical k � t CtM C� �� C Tnt Mechanical Plumbing Framer. Roofing 0"o PCX, Concrete Fireplace Solar Other . Other Other Applicant: I. hereby-aclmowledge ttiet:I.have: read:this application and .stat@ 16t.the above information is correct agree to comply with all requirements contained herein.and C4 of Fort Collin ancee nd state laws regulating building construction. Applicant:Signature �Print Name Phone �i7d —ZCq 77 Distribution: White — Office Yellow — Applicant Pink = WWW/Stormwater ':..:...::.::...:..... iH1� A��L P� 1������ F�A��,IC� DATE llOc�SZ�J